Other Viral Hepatitis Infections

Hepatitis A

Hepatitis A (HAV) is found in faeces (stool). People become infected
when faeces from an infected person enters their
mouth. This may occur when food (including raw or
undercooked shellfish) or water are contaminated with
sewage, or when an infected person handles food
without washing his/ her hands after going to the toilet,
through oral-anal sex (rimming) and rarely, from blood
transfusions.

A vaccine is available against HAV, but it is less
effective in people with low CD4 cell counts.

Some people -- especially children -- don't feel sick at all;
others have symptoms, including: nausea, vomiting,
diarrhoea, fever, fatigue, rash, jaundice (yellow skin
and eyes), liver pain, and dark brown urine. There is
no treatment for HAV, but the symptoms can be treated.
It is not a chronic infection.

A person can only be infected with HAV once. HAV
goes away by itself, usually within two months

Hepatitis B

Hepatitis B (HBV) can be found in blood, semen, and vaginal fluid
of infected persons. Very small amounts of HBV
have been found in breast milk and saliva. A person
can get hepatitis B from sharing injection or tattooing
equipment, unprotected anal, vaginal or oral sex,
and by sharing personal care implements (such as
toothbrushes and razors). HBV can be passed from
mother to child during birth.

HBV can be treated with interferon and oral antiviral
drugs, such as adefovir, and telbuvidine. Some HBV
drugs are also active against HIV, such as: lamivudine
(3TC), emtricitibine (FTC), tenofovir and entecavir.

As with HIV, antiviral HBV treatment should not be
given as monotherapy to people with coinfection.
Coinfection guidelines provide detailed information on
drug choices. For example, they currently recommend
starting HIV treatment earlier, and including tenofovir
plus either 3TC or FTC, plus at least one extra drug so
that there are at least three active drugs against HIV.

Another very important caution is that once HBV
treatment is started, unless the infection is completely
cleared, HBV treatment should not be stopped.
Removing HBV drugs can cause a serious flare of liver
enzymes that can be fatal.

If HIV treatment needs to be changed, then the
HIV drugs that are active against HBV need to be
maintained in the next regimen.

Other viral hepatitis infections

There is less research on coinfection with other viral
hepatitis infections. These include:

Hepatitis D -- an infection that only occurs in some
people with hepatitis B. HDV increases the risk of
cirrhosis and the rate of liver disease progression for
people with HBV. Vaccination protection against HBV
also protects against HDV infection.

Hepatitis E -- a separate infection, with similar
characteristics to hepatitis A. HEV will clear without
treatment over several weeks to months. There is no
vaccine for HEV. You can only be infected with this
virus once. It is not usually serious, except during
pregnancy.

Hepatitis F -- thought to be a new virus similar to
hepatitis B, but recent research failed to confirm this.

Hepatitis G (HGBV-C) -- a virus with structural
similarities to hepatitis C. The role and importance of
hepatitis G is unclear, especially in someone with HIV.
Some research suggests that hepatitis G may slow HIV
progression. Other research suggested that clearing
hepatitis G could make HIV more serious.

This article was provided by HIV i-Base. It is a part of the publication Hepatitis C for People Living With HIV. Visit HIV i-Base's website to find out more about their activities, publications and services.

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